Research in context
Evidence before this study
Population-based observed data of 5-year net childhood (0–14 years) cancer survival for acute lymphoblastic leukaemia, lymphomas, and brain tumours from 322 cancer registries globally have been reported in the CONCORD-3 study. The CONCORD-2 study previously provided similar population-based 5-year net-survival estimates for both acute lymphoblastic leukaemia and acute myeloid leukaemia. We searched PubMed for studies on global childhood cancer survival using the search terms “childhood cancer”, “survival”, and “global” on Feb 28, 2019, without language or publication-date restrictions. We found no other estimates of global childhood cancer survival. Although few data from low-income and lower-middle-income countries are available, they indicate considerable variation in survival by region.
Added value of this study
With major geographic and histological gaps in the observed 5-year net-survival statistics, there are no global estimates of how many children survive cancer. This study provides, to our knowledge, the first estimate of global childhood cancer survival, based on a simulation model for 200 countries and territories and 48 cancer diagnoses. We provide global, regional, and country-level estimates of 5-year net cancer survival for all International Classification of Childhood Cancer (third edition) subgroups and estimate the potential impact of various policy scenarios to help guide priority-setting efforts aimed at improving survival.
Implications of all the available evidence
The estimated gap in childhood cancer 5-year net survival between high-income and low-income countries is more than 70 percentage points. Thus, the most important prognostic factor for whether a child will survive cancer is where he or she lives. Our model-based findings suggest that although improving the availability of treatments and mitigating treatment abandonment are necessary interventions to achieve high survival, they are insufficient if implemented alone. Concurrent improvements in health systems to ameliorate quality of care will also be needed to substantially increase childhood cancer survival worldwide.